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目的 :研究肝硬化患者Child -Pugh分级 (CP分级 )与血清前胶原Ⅲ肽 (PⅢP)水平的相关性。方法 :2 72例病例入院后即检测血清PⅢP、谷丙转氨酶 (ALT)、谷草转氨酶 (AST)、总胆红素 (TBIL)、凝血酶原时间 (PT)、白蛋白 (ALB)、白蛋白 /球蛋白 (A/G)等 ,此后每 2月检测 1次。按CP分级标准将病人分为A、B、C 3级。计算各级PⅢP值与正常人之间、各级之间、同一病人不同CP分级状态之间、同一病人同一CP分级不同时期之间的差异以及各级PⅢP值与有关生化指标的相关性。追踪观察各级CP患者出现高PⅢP值者预后情况。结果 :A、B、C 3级PⅢP值均明显高于正常人 (P <0 0 1) ;3级之间PⅢP值也有明显差异 ;同一病人不同时期不同分级状态PⅢP值存在明显差异 (P <0 0 1) ;各级中出现高PⅢP(>2u/ml)者半年内的死亡率 (36 7% )明显高于PⅢP值 <2u/ml者 (8 5 2 % ) (P <0 0 1) ,即使是A级出现高PⅢP值者 ,预后也差。结论 :血清PⅢP值对肝硬化诊断具有重要意义 ,在一定程度上可以反映肝硬化患者的肝功能状态 ,同时对评价肝硬化患者肝功能状态及预后也有一定临床价值。
Objective: To study the correlation between Child-Pugh classification (CP grade) and serum procollagen Ⅲ peptide (P Ⅲ P) level in patients with cirrhosis. Methods: Serum PⅢP, ALT, AST, TBIL, PT, ALB, albumin / Globulin (A / G), etc., since the test once every two months. The patients were divided into A, B, C 3 grades according to CP grading standards. The differences between PⅢP values at various levels and normal subjects, between different levels, between different CP grading states of the same patient, between different stages of the same patient with the same CP grade, and between PⅢP values at various levels and relevant biochemical indexes were calculated. Follow-up observation of CP patients at all levels of high P Ⅲ P value prognosis. Results: The PⅢP values of grade A, B and C were significantly higher than those of normal controls (P <0.01). There was also a significant difference of PⅢP between grade 3 and grade P Ⅲ P in different grades (P < (P <0.01). The half-year mortality rate (36.7%) in patients with high PⅢP (> 2u / ml) was significantly higher than that in patients with PⅢP <2u / ml ), Even if the A-high P Ⅲ P value appears, the prognosis is poor. Conclusion: The serum PⅢP value is of great significance for the diagnosis of liver cirrhosis. To a certain extent, it can reflect the liver function status of cirrhotic patients. It also has certain clinical value in evaluating the liver function status and prognosis of patients with cirrhosis.